New Research From Clinical Psychological Science

COVID-19 Stress and the Health of Black Americans in the Rural South
Olutosin Adesogan, Justin A. Lavner, Sierra E. Carter, and Steven R. H. Beach

Prepandemic stressors and lack of resources might have exacerbated COVID-19’s effect on the mental and physical health of Black Americans in the rural South. Adesogan and colleagues tested 329 Black Americans before the pandemic and during summer 2020. They found that participants reported worsening health, including increased depressive symptoms and sleep problems, after the onset of the pandemic, with those more exposed to COVID-19 stressors (e.g., job losses) reporting poorer health. Prepandemic stressors such as financial strain, racial discrimination, and chronic stress, along with lack of resources (marital quality, social support), were also associated with exposure to COVID-19 and poorer health.

A Sobering Look at Treatment Effectiveness of Military-Related Posttraumatic Stress Disorder
Ofir Levi, Ariel Ben Yehuda, Daniel S. Pine, and Yair Bar-Haim

Levi and colleagues analyze the effectiveness of treating veterans who have posttraumatic stress disorder (PTSD) in real-world clinical settings, using trauma-focused cognitive-behavioral therapy, psychodynamic psychotherapy, or pharmacotherapy. Assessing veterans’ PTSD and depression symptoms before and after treatment, they found that PTSD remission was 39.4%, whereas depression remission was 4.1%. Treatment was least effective for intrusion symptoms and did not affect flashbacks or poor recall of traumatic events’ features. By understanding which symptoms respond to treatment, researchers and clinicians could develop new treatments or extend current treatments to target PTSD symptoms that do not respond well to existing treatments.

Answering Questions About the Hierarchical Taxonomy of Psychopathology (HiTOP): Analogies to Whales and Sharks Miss the Boat
Colin G. DeYoung et al.

DeYoung and colleagues comment on the questions Haeffel and colleagues (2021) raised about the Hierarchical Taxonomy of Psychopathology (HiTOP), a classification system that clusters symptoms of mental illness into dimensions of psychopathology rather than the classic diagnostic taxonomies. DeYoung and colleagues explain the HiTOP system, which is descriptive and atheoretical, and discuss how one of its strengths is that it is designed to be falsifiable and revised according to data. The authors review evidence for HiTOP’s external validity and its scientific and clinical utility, including how it is currently used in clinics and how researchers are working to address its potential limitations.

Alcohol’s Effects During Uncertain and Uncontrollable Stressors in the Laboratory
Daniel E. Bradford et al.

Bradford and colleagues compared the effects of alcohol and no alcohol on recreational drinkers’ reactivity to stressors (shocks) that varied in their perceived certainty and controllability (participants only sometimes knew and/or could control the shocks’ intensity). Results indicated that alcohol reduced self-reported anxiety and defensive reactivity (measured by startle) more during uncertain stressors than during certain stressors regardless of controllability. Thus, recreational drinkers exposed to uncertainty in their lives may be at risk of using alcohol to dampen their stress reactivity, even if they can control some aspects of that uncertainty.

The Effect of COVID-19 Lockdowns on Maternal Mental Health and Parenting Practices Moderated by Urban Green Space
Marigen Narea et al.

Narea and colleagues studied the impact of COVID-19 lockdowns on maternal mental health and parenting practices, along with the extent to which green space could be a protective factor in that relationship. They used longitudinal georeferenced data for 985 families (mothers and 24- to 30-month-olds) in Chile. On average, the researchers did not find an overall association between lockdown duration and maternal mental health or parenting practices. However, data were heterogeneous: Lockdown duration increased dysfunctional parent-child interactions for mothers with little access to green space but not for mothers who lived close to green space and did not comply with the lockdown mandate.

Which Anxious Adolescents Were Most Affected by the COVID-19 Pandemic?
Santiago Morales et al.

In a longitudinal study, Morales and colleagues used parent reports, self-reports, and clinical diagnostic interviews to assess adolescents’ social anxiety and generalized anxiety levels. Later, when these adolescents were young adults during the pandemic, the researchers assessed anxiety, stress, and COVID-related worries at three different times. Prepandemic generalized anxiety predicted higher initial levels and maintenance of anxiety, stress, and COVID-related worries during the pandemic. In contrast, prepandemic social anxiety predicted lower initial levels of anxiety, stress, and COVID-related worries, but that existing social anxiety later offset the initial reduction in anxiety and stress.

Continuities and Discontinuities in the Cognitive Mechanisms Associated With Clinical and Nonclinical Auditory Verbal Hallucinations
Peter Moseley et al.

Moseley and colleagues tested how individuals with and without auditory verbal hallucinations (AVHs) performed different cognitive tasks. Within the group of voice hearers, they compared two groups of participants: those with psychosis and those without any need for care (nonclinical voice hearers [NCVHs]) who reported hearing spiritual voices. Compared with non-voice-hearers, voice hearers with psychosis showed atypical performance on auditory signal detection, dichotic listening, and memory-inhibition tasks but intact performance on a source-monitoring task. NCVHs showed only atypical signal detection. These findings suggest that clinical and nonclinical individuals with AVHs may differ in terms of attentional control and inhibition of intrusions.

Changes in Maternal Depression and Children’s Behavior Problems: Investigating the Role of COVID-19-Related Stressors, Hair Cortisol, and Dehydroepiandrosterone
Stacey N. Doan, Madeleine Ding, Anna Beth Burniston, Patricia A. Smiley, Chong Man Chow, and Cindy H. Liu

To study the impact of COVID-19-related stressors (CRSs) on the psychological adjustment of mothers and children, Doan and colleagues tracked changes in maternal depressive symptoms and children’s behavioral problems from approximately 2 years before the pandemic (T1) to May through August 2020 (T2). Results suggested that maternal and child adjustment were correlated, children’s internalizing symptoms (e.g., anxiety) increased, and exposure to more stressors was associated with increased maternal depressive symptoms. Also, higher levels of maternal hair cortisol at T1, but not dehydroepiandrosterone (a hormone released with cortisol during stress response), were associated with significant increases in depressive symptoms.

A Comparison of Mental-Health Outcomes in the United States and Italy at Different Levels of Cumulative COVID-19 Prevalence
Anthony D. Mancini and Gabriele Prati

Mancini and colleagues studied how the prevalence of COVID-19 affected people’s mental health in four regions in the United States and Italy—two regions with high prevalence (New York City and Lombardy) and two regions with low prevalence (San Francisco and Campania). Prevalence’s effect on mental health depended on the country: Compared with low prevalence regions, high prevalence in the United States was associated with more general distress, posttraumatic-stress-disorder (PTSD) symptoms, and COVID-19 worry, but the opposite happened in Italy. The researchers also found that greater consumption of media related to the pandemic occurred in regions with worse mental health outcomes.

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